What Do You Remember?

I became conscious with an intense throbbing headache when my boss called to ask if he forgot I had the day off from work. I was laying in bed with my phone in my hand, set to vibrate and not to ring. It was 11:45 a.m. The last time I saw a clock was three hours earlier. My head was wet and felt like it was exploding. I staggered a few steps out of the small bedroom to the kitchen, and leaned against the wall. The answer to my boss’ question was on the floor: a giant crimson pool of blood the size of a garbage can lid. I wasn’t going to work.

Without seeing how purple and swollen my face was, the eruption of pain in my head indicated this was a serious injury. I immediately called my doctor and said I was coming over. Relying on myself to get anywhere safely, including through the day, was out of the question. I called Jason King: “Jason, can you come over? Something bad happened and I need your help right away.” Jason was on sabbatical from teaching that semester, and lived a few blocks away. What luck. To spare Jason the fate of fainting at the site of the blood or slipping in it, and the two of us needing an ambulance, I wiped up the quarts of blood that laid before the front door like a welcome mat and continued getting dressed.

Jason did a good job of not alarming me with frightened stares and gasps, and got me into a cab. Unlike Jason, my doctor’s receptionist was not professionally trained in theatrical performance and able to keep a straight face. She spoke with me as though she were calmly trying to talk me out of jumping from a window. One near-fatal fall was enough for me though.

I introduced Jason to my doctor: “Dr Kessler, this is Dr King.” Jason had to clarify to the puzzled Dr Kessler that he was a music professor, and not a medical doctor. This is when I realized my mental functioning wasn’t prime. The bad headache was blamed. “Emergency rooms aren’t much fun, but that’s where you need to be.” Dr Kessler called New York Presbyterian hospital to check me in.

The first nurse to attend to me was affable. Referring to Jason, he asked me “Did he do this to you?”

“No. It’s not that kind of relationship.”

“Oh, that’s better. Are you guys getting married since it’s just been made legal? You might get lower insurance premiums, and it looks like you could use them right about now.”

“No. It’s not that kind of relationship either.”

The nurse’s attempt to make us laugh slightly amused me, despite the terrible pounding in my head. Jason was more practical, advocating for anyone sensible to come attend to me, making sure I was still alive while making arrangements on my behalf: a dental check-up for that evening was cancelled. Weeks later, the appointment was rescheduled to remove a newly shattered tooth from my crooked jaw. Friends were called. My boss was updated: I was alive, but not coming to the office any time soon. My brother from whom I was renting an East Village apartment was assured that nothing in the apartment broke; he came to make sure I had not broken either.

The new age minister I’d begun dating recently [Yes: the atheist and the minister!] was asked to come to the hospital. He persevered to find me in the labyrinth of corridors that all looked alike, staying about twenty minutes for his first and only visit the hospital. Later, he complained about a friend of his with fatal cancer who wanted him to come pray with her at the hospital she was dying in. He struggled with his schedule, concluding that she had enough people to spend time with her, and that he couldn’t see her as often as she wanted. Over a month later, when on my way to see him briefly in between his daily work assignments, I realized he didn’t have enough time for me either.

The hospital housed me in a private ICU room for three days, and a swirl of white-jacketed workers came and went, leaving little impression on me about my condition, but asking the same questions each time: Did I have seizures? Did I have heart problems? Did I have any allergies? Did I know where I was and which war criminal was president? After being discharged, on my first of many near-daily follow-up doctor visits, my doctor intimated that the hospital kept calling him to ask if I might have been hiding a narcotics habit that I overdosed from. He told them I didn’t even eat sugar, and to stop asking.

“What do you remember?‚ This was the most vexing repetitious question I grew tired of answering. My responses never could develop beyond their inherent lack of specificity, and please the person who was asking for more details: “I don’t know what happened. I was putting in my contact lenses, and then woke up three hours later with a bloody head wound. Please˛tell me I’m not dying, that I can be normal again, that I won’t be helpless and mentally feeble if I wake up tomorrow. Further interrogations belittled my attempts to avoid feeling inferior for not being able to retell the gruesome details that preceded becoming unconscious. Raising my head to listen and talk was an effort. There cannot be a TV instant replay. My life is not a recorded video that can be rewound and watched in slow motion.

I remember anxiously crying without warning.

I remember lacking ability to be socially graceful while being tormented by relentless pain.

I remember not feeling grateful for life. I feared checking out of the hospital and into a cardboard refrigerator box on the street because my level of debt inevitably would rise higher than my debilitating pain.

When I say “I don’t remember what happened” that means it’s your time to forget it. Anyone in a hospital bed is supremely vulnerable.

Much of the time I was hospitalized, I was asleep. When I awoke, I was uncomfortable at best.

I woke up in pain, and fell asleep in pain.

I fell.

I fell in pain.

Falling.

Falling.

Falling, painfully.

I’m sore right now.  

Visiting friends made it more bearable, bringing love and familiarity to such an alien environment and frightening ordeal, even if I didn’t have enough energy to hold conversations for long. I’m thankful for the time with Aldo, Elisa, Jason, Joyce, Kevin, Ronnie, and Suheir.

One nurse was asked for serious drugs for my head pain. She returned looking into a small cup and announced: “Things are looking good for you; although, you may not want to hear this part: you’ve been reduced to Tylenol.”

After many IV bags filled with water, vitamins, and drugs, somewhat reasonable food (steamed vegetables and brown rice), CAT scans, X-rays, and MRIs, I was free to go. I don’t know who took me home, but that friend made it happen; I sure couldn’t. [It was Suheir.] Remembering anything but my multiple contusions was hard.

Once home, Axel, Elisa, Jason, my mom and nurse/nun aunt, Suheir, Tarek, and others visited to bring me flowers and groceries, make meals, take me to doctors, make sure I wasn’t dying, and genuinely comfort me. Often, I had little social ability, and visits were brief, despite how much I wanted to feel engaged with the life I remembered as being normal. Nightly, I slept thirteen hours, and needed naps after fifteen minute phone calls. Exhaustion quickly pulled me back into unconsciousness the way I imagined death to be sudden and unpredictable.

Imagine waking up in the middle of the night with a terrible leg cramp caused by a bedside fan, motionless legs, cooler body temperature, etc. This happened to me all the time, but while awake. Every time I sat up, sat down, stood up, bent over to tie my shoes, or turned in bed, awful spasms seized my legs. Twice a week, I saw an acupuncturist who specialized in helping stroke patients regain motor control. He told me that one night in an undulating hospital bed that redistributes the patient’s weight on its mattress—like the one I laid on for three days—would cause these symptoms. Weeks and lots of stretching passed before the spasms subsided and I could try to walk more than a few feet with speed. Until then, old ladies with walkers outpaced me on the sidewalk, bolstering feelings of regression.

Thinking I was better enough to travel uptown to a doctor alone and on the subway (and knowing I was poor enough to not be able to take a taxi), I was overwhelmed by the aggressive race everyone else turned their commutes into. Walking down stairs was a slow undertaking. The sudden shift in light from bright midday sun, to the darker subway platforms, to the super-white train interiors became unbearable. The disharmonious screeching of lurching trains rocked my senses. Above ground, I was so exhausted, I could barely remember to make myself turn my head and look for cars coming at me before crossing the street.

Back inside my apartment, the windows and curtains remained closed. Average daylight and ambient sounds like street traffic and neighbors slamming their doors disturbed me. The radio and music that normally comprised the soundtrack in my apartment were unlistenable. Friends’ voices that I wanted to hear irritated me. My head hurt in silence; any additional sounds made me feel worse.

Clinical History

38-year-old male.

Status: post-head trauma, 1 week ago, with left temporal fracture.

Pressure right-sided and decreased right-sided hearing.

Technique

Internal MRI scan of the brain and internal auditory canals without and with gadolinium. The examination was performed with sagital T1-weighted and axial FLAIR, T2-weighted, gradient echo, and diffusion-weighted images of the brain. Axial 3-D FIESTA images of the internal auditory canals were also obtained.

Impression

Enhancing confluent signal abnormality of the anterior inferior right frontal lobe with associated blood product consistent with hemorrhagic contusion. There is non-hemorrhagic contusion involving the anterior right temporal lobe and the inferior left frontal lobe.

Opacification of the right-sided mastoid air cells

Right frontal developmental venous anomaly

Comparison

No prior studies are available for comparison

The swelling of my eyes and resulting pressure in my orbits compromised sight. Most things looked blurrier than I remembered them to be. When outdoors in the bright summer sun, seeing was not automatic; involuntary functions required a serious conscious effort. Wearing contact lenses and sunglasses wasn’t an option for weeks, and my glasses offered no protection from the piercing white daylight. Brightly colored spots and ambiguous shapes ricocheted through my field of visionlessness, causing me to look downward at the ground in avoidance when I walked outside. This has continued to happen.

I tried typing and my fingers had dyslexia. Reading was agonizing; my eyes kept refocusing, blurring letter shapes. I thought my eyesight might worsen permanently. I wondered how bad my condition really was. My severe nearsightedness was bad enough already; at more than three feet away, details deteriorate. In the hospital, I kept my glasses on at all times so I could try recognizing who came in the room, a place so public and frequented by strangers whose roles and faces I couldn’t distinguish or remember.

Getting up from my computer in the living room, I walked purposefully into the bedroom. Once there, I didn’t know why I had come into the room. “This isn’t brain damage,” I told myself rationally. “It’s just coincidence, a sign of aging.” But I wasn’t even 40. In years prior, Carole and I had joked that it was early Alzheimer’s.

I remembered black and white photo darkroom chemistry procedures: photos sat no longer than 30 seconds in stop bath before moving to the fixer. The keyboard command for scaling a photo proportionately to fit a box in QuarkXPress was Command-Option-Shift-F. I’ve not seen the black interior of a darkroom in almost twenty years, and they hardly exist anymore. Quark was out-placed as the industry standard page layout program by InDesign almost a decade ago.

A neurological exam didn’t involve electrodes and computer analysis of brain signals. Instead, the doctor tested my memory and faculties with mathematics for which, over the years, I’d grown to rely on calculators, much like anyone else:

“Count backwards from one hundred to zero in increments of seven,” the neurologist instructed me in a deliberately non-triggering monotone voice.  

“One hundred, ninety-three…sixty-five…wait—let me start over—one hundred, ninety-three…eighty-six…”

Afterward, I stumbled through multiplication tables with humility and more respect for primary school math students.

I remember coming home from school one day, profoundly upset, crying about not understanding the concepts of multiplication that my classmates seemed to comprehend. My father—a university mathematics professor—tried to help, but wound up resigned to walk off, laughing. I was in the third grade, and felt more feeble that day.

Ashwagandha, B vitamins, betaine hydrochloride, butterbur, choline, ginko biloba, ginger, ginsengs, gotu kola, holy basil, inositol, L-glutamine, L-methionine, L-tyrosine, quercetin, RNA, turmeric: all these natural supplements would reduce stress, feed my brain, enhance neuro repair, and reduce inflammation. These pills were added to the handfuls of vitamins I normally swallowed several times daily, scared by the alternative of devolving into a zombie if I stopped.

Two weeks after getting out of the hospital, I ambitiously did not go home right after a treatment with the uptown acupuncturist, and took a walk in Union Square Park. The farmer’s market offered an opportunity to stimulate my senses with the fragrances of vegetables, herbs, and flowers: calla lilies, honeysuckle, cut watermelon, beets, basil, and thyme. Closing my eyes to smell them reminded me how easily pleasure can be found.

The human resources director at my job called to interrupt this momentary luxury: “Remember how I said the company’s private disability insurance would cover your time off at your full salary? I was wrong. They’ll only pay up to half of your salary.” That disability insurance company already conducted a phone interview to assess how jacked up I really was. I’d labored to interpret how to fill out claim forms to initiate the coverage. All of the paperwork had to be mailed for next-day delivery with copies of hospital reports, discharge papers, X-rays, etc.

My head wasn’t likely to heal enough for me to work full time again for at least a couple of months. That was the prediction I tried to keep faith in. I could barely stay awake, and was advised to call the disability insurance company to work out a deal. A person with full faculties would have been challenged by all this messy bureaucracy.

The disability insurance representative couldn’t hear me over the loud yells and chants of the children carrying on in the playground. This outing turned sour, eroding the little energy I had left. Fatigue weighed heavily on me and knocked me out as soon as I got home.

Desperate to make sure I was getting paid, I met with the human resources director at my job to review the number of paid days off I had left, and to figure out how long I could stay out of work before filing for the state’s disability. A popularly disliked coworker stopped me as I slowly walked through the hall in my office. “I can’t believe this happened,” she said, as if to deny all the trauma I was enduring. My split-open head—with its blood leaking out improperly in public—was ruining her illusion of safety.

Her choice of bad idioms yielded more veiled blame than compassion. A more appropriate response from her would have been “I’m so sorry to hear of your accident. You must be in terrible pain. Thank goodness you’re alive.” But, no. Even alive, I was a nuisance to her.

Weeks earlier, this same worker insensitively asked “which one of them died?” referring to my employee who died unexpectedly of a heart attack at fifty-two.

“Philippe.”

“Philippe? Which one was that? It wasn’t Mike. Who was it? Tell me! Who died?”

“The dead one!”

I walked off, and she called after me “Come back. Who was it?!”

There were only seven people in my department and she’d worked at this sixty-person company longer than most of us, including Philippe, who worked at this job for five years. Patience had bleed out of me. Neither my patience, nor Philippe, could come back.

Bills from the hospital and all its workers started coming. On top of the $15,000 room, they charged me 53¢ for every Tylenol. The doctors must have advised each other to stop by my room just so they could bill for their momentary visits. Every week, the mail contained new bills from unknown doctors at the hospital; sometimes, the same bill came twice, leaving me to decipher the difference between the original and the duplicate bills. United Healthcare claimed they would pick up the tab from then on since I’d met the “out-of-pocket” maximum; I’d paid enough on my own for health services the insurance would not cover.

United Healthscare only paid as much as they felt like, and I got stuck with tens of thousands of dollars of medical debt, even for services that the insurance had not disqualified from coverage earlier in the year, but now started to dismiss as unreimbursable. I wrote letters and called them to protest: “I almost died and have a serious head injury. I’m beyond broke, unable to work, and can’t afford to pay these bills.” They didn’t give a shit and neither did the hospital.

I had to move to a cheaper apartment on an undesirable block in otherwise-nice Prospect Lefferts Gardens. I liked the area but not the park across the street that was the neighborhood’s loud hang-out spot. Sounds of soulless corporate hip hop blaring from car stereos, glass bottles smashing, drunken yelling, arguing, and occasional fighting were a nightly backdrop to sleep.

“Yo, just bring him home.”

“Hell no! I helped him enough. His shoe fell off and I picked it up!”

—two guys arguing over the passed-out drunk paraplegic who was slumped over in his electronic wheelchair in front of his residence at 320 Sterling St, Monday, 2:30 a.m.

Eagerly, I planned to move out, but was trapped another year because the IRS began to audit two years of my tax filings, questioning the tens of thousands of dollars of medical deductions I claimed.

For once, I agreed with the government. They thought I spent too much money on my medical bills. Death is not cheap. Fighting death costs even more. The government wanted me to prove this. Audit accountants aren’t cheap, either. Moving was not an option, and it took a year of my constant work to resolve the audits. Every aspect of each claim had to be remembered and proven, documented line by line. Six stories above the noisy street, two years of doctor appointments, cab rides to those appointments, prescribed drugs and supplements, and so on were typed into Microsoft Excel spread sheets.

In the meantime, I was used by the building’s management company as a pawn in gentrification. They never responded to my complaints about the super blasting TV and music through the night, which frequently woke me at 3 a.m. with video game sound effects played at movie theater volume levels. He lived in the apartment below mine, so his bad behavior was an effective strategy for driving out tenants.

A lease renewal notice arrived, offering the opportunity to renew the lease and pay $380 more in rent each month. The rent increase was legal, but by no means ethical in all its implications: if one white person could live in this neighborhood/on this block/in this building, then countless others should want to as well. The existing community members surely would not be likely to put up with or be able to pay such unreasonable increases.

A former coworker who survived a brain aneurism reasoned “I have a stack of X-rays half a foot high. Should I have said ‘no’ to the doctors who said I needed them? At what point do you put a limit on the price you pay for your head?”

I didn’t pay with my life—only a few years of it.

Did I recover financially? No. I paid $80,000.

Did I recover mentally? Not entirely. Problems persist. Bright lights bother me. Car LED headlights blind me. In the past, headaches were rare. Now, they are frequent. Sometimes, my head is sore for days. Work is harder, requiring more uninterrupted concentration and effort to be available to others and to perform accurately.

I can’t remember what ads I worked on a few days ago. My capacity is limited for recalling exact repetitive tasks since they are numerous and the projects look the same. Part of my job is to make them look the same. That I can do.

While life was never easy, and I purposely chose a radically conscious way of being, I don’t remember circumstances being as demanding. New York City is defined in part by its offering of polarizing excesses. There is too much of most everything except cheap apartments, peace of mind, compassion, and—right now—men with sensible facial hair. The city that never sleeps needs to take a nap. So do I. My safe response to the city’s overpopulation is social withdrawal.

The once-gregarious me has become more introverted and asocial in self-defense. My ability to accommodate frequent social interaction has become limited. I lost that in the fall. And without enough sleep, I am more incapacitated in my new limitations. Coworkers get the best of my social faculties, unfortunately, leaving me less inclined to spend time with people I actually like. It isn’t that I don’t want to interact. I can’t. My range of availability is reduced.

I don’t remember being so deeply tired.

I don’t remember being in such a financial quagmire.

I remember names.

I remember dates.

I remember birth dates.

I remember death dates.

I remember the day I almost died.

It was three years ago today.